Hypersomnia is a neurological sleep disorder, characterized by excessive daytime sleepiness often in co-occurrence with excessive hours of sleep. Hypersomnia can be a primary sleep disorder, or occur as a result of other disorder, other illnesses, lifestyle choices or as a side effect of medication. It presents both a physical burden on the sufferer, but also has mental, emotional and social impacts.
Symptoms Of Hypersomnia
The two main symptoms of hypersomnia are excessive daytime sleepiness and prolonged nighttime sleep.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t taken as medical advice, and it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
There are many secondary symptoms of hypersomnia, too. These can include emotional problems such as low mood, anxiety or irritability, physical symptoms such as loss of appetite, restlessness or slowness of movement or speech, or mental symptoms like slowness of thought, issues with memory, and even hallucinations. Most sufferers of hypersomnia report suffering from what’s known as sleep inertia upon waking. This refers to a feeling of confusion and even total disorientation upon waking, and a longer time transitioning from sleep to wakefulness.
For a hypersomnia diagnosis, the symptoms of excessive daytime sleepiness and excessive hours spent sleeping must have been going on for at least three months. The severity of the excessive daytime sleepiness can be tested in subjective or objective ways. And only a qualified medical professional can accurately diagnose sleep disorders like hypersomnia.
A subjective test for sleepiness is the Epworth Sleepiness scale, which is a short questionnaire in which people rate the likelihood of them falling asleep during a number of day-to-day activities. The higher the score, the higher the chance the participant is suffering from a sleep disorder.
An objective test is the Multiple Sleep Latency Test, which tests brain waves during naps and the overnight sleep cycle.
Once excessive daytime sleepiness is diagnosed, it is often followed with a full medical examination to screen for potential causes, alongside tests to screen for other sleep disorders.
Types Of Hypersomnia
There are two primary types of hypersomnia: primary and secondary. Primary hypersomnia means the hypersomnia and its symptoms are the main issue, while secondary hypersomnia means the hypersomnia is concurrent with another medical issue.
Primary hypersomnia includes narcolepsy (a sleep disorder of excessive daytime sleepiness and “sleep attacks,” where an individual immediately and uncontrollably falls asleep), Kleine-Levin syndrome (a rare sleep disorder categorised by periods of excessive daytime sleepiness and increased hours of sleep, followed by a period of hyperphagia, hypersexuality and heightened wakefulness), and idiopathic hypersomnia.
Idiopathic hypersomnia is hypersomnia with no known cause. Sufferers can live their lives in a state of drowsiness and never quite feel fully rested or awake – in spite of getting more sleep than is medically needed. It comes with a social stigma, because the lack of cause may make people view it as laziness. However, it’s a very real sleep disorder.
Secondary hypersomnia are easier to find a cause for, and therefore are often much easier to treat. It is defined as hypersomnia in concurrence with something else – either another sleep disorder, another medial issue, or a drug side effect, for example.
Causes Of Hypersomnia
Idiopathic hypersomnia has no known cause. By definition, it is extreme need for sleep and excessive daytime sleepiness with no clear reason.
Other primary hypersomnia such as narcolepsy and Kleine-Levin syndrome do have causes. Narcolepsy is sometimes a result of an autoimmune response destroying hypocretin receptors – in layman’s terms, the body destroys the substance the brain produces in order to organize wakefulness and sleep. Kleine-Levin syndrome is thought to be a result of problems with the temporal lobe of the brain, alongside hormonal imbalances.
Secondary hypersomnia is linked to maladies such as multiple sclerosis, epilepsy and obesity. It also has ties with mental health issues, most prevalently with major depressive disorder. There are also links between hypersomnia other sleep disorders. Secondary hypersomnia can be a result of severe head trauma, too.
Hypersomnia can also be caused by lifestyle. It can be a result of drug or alcohol abuse, and is commonly resultant as a side effect of either taking prescription drugs, or withdrawal from them.
Hypersomnia And Other Sleep Disorders
Sleep apnea is usually the most common cause of secondary hypersomnia. Those who suffer from sleep apnea experience periods of extreme shallowness of breath or even prolonged pauses of breath during sleep. It hugely disrupts the sleep cycle and can minimize the quality of an individual’s sleep. Thus, in spite of seemingly sleeping for many hours, the sufferer never feels well rested and is very tired throughout the day.
Another sleep disorder associated with secondary hypersomnia is restless leg syndrome. Restless leg syndrome is categorized by a strong and irresistible urge to move one’s legs, particularly during periods of rest. Some sufferers describe an extremely uncomfortable or almost painful sensation in the legs which can only be alleviated through movement. As with sleep apnea, this disorder massively negates quality of sleep, and can thus be concurrent with hypersomnia.
Treatment For Hypersomnia
Hypersomnia can be treated with stimulants, such as modafinil or Ritalin, which are commonly used to treat attention deficit disorder. Again, only a qualified medical professional can accurately diagnose sleep disorders and/or prescribe medications to treat them. They can help a sufferer feel more awake, well-rested and focused during the day. Some antidepressants such as fluoxetine, sertraline or citalopram are also used to treat hypersomnia. In sufferers of both hypersomnia and narcolepsy, sodium oxybate may be prescribed at night to maximize restfulness and thus improve daytime sleepiness. However, taking drugs over time can make the effects less efficient, and produce some troublesome side effects.
Lifestyle changes can also mitigate the effects of hypersomnia. Getting into a good night time routine, by going to bed at the same time every night can help your body know when it’s time to sleep. Good sleep hygiene – using your bed only for sleep and sex and avoiding electronics in bed, for example – can also help. In order to maximize the restfulness of sleep, it’s recommended to avoid caffeine, alcohol and large meals before bed.
If you’re concerned about the sleeping habits of yourself or someone you know, it’s always worth consulting with a doctor.
Annie Walton Doyle
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